Highlights
- •Tablet burden is often substantial, and can cause significant inconvenience.
- •There are significant potential risks associated with polypharmacy.
- •Benefits of treating chronic conditions in these patients are questionable.
- •A more critical approach is needed regarding concomitant medications.
Abstract
The implications for patients with cancer, of the ‘tablet burden’ resulting from increasing
use of oral anticancer drugs and medication for co-morbidities have not previously
been well explored.
Aim
We sought to (i) quantify tablet burden in women with metastatic breast cancer (MBC),
(ii) establish which groups of drug contribute most to this burden and (iii) gain
insight into patients' attitudes towards oral anti-cancer treatment.
Methods
One hundred patients with MBC anonymously completed a questionnaire describing their
medication histories and attitudes towards their tablets.
Results
The patients (mean age 60, range 31–95) were all female and taking a median of six
tablets (range 0–31) daily; 37 patients were taking >10 tablets. Oral anticancer treatment
constituted the category of treatment taken by the highest proportion of patients,
followed by symptomatic cancer treatments, proton pump inhibitors and cardiovascular
medication. Numerically, however, symptomatic drugs accounted for 44% of all tablets
and specific anti-cancer treatment for 15%; medication not directly related to the
cancer accounted for the remaining 40% of tablets. A quarter of patients reported
inconvenience in taking their tablets, the main reason being tablet size and one third
reported forgetting their tablets at least once a week. Nearly two thirds of patients
expressing a preference favoured oral anticancer treatment, the commonest reason being
greater convenience.
Conclusion
Tablet burden is considerable for many patients with MBC and can be problematic. A
significant proportion of tablets represent treatment for co-morbidities, the significance
of which may be questionable in women with MBC.
Keywords
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Article info
Publication history
Published online: December 28, 2015
Accepted:
November 12,
2015
Received in revised form:
October 15,
2015
Received:
August 13,
2015
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
